Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 51
Filtrar
1.
Stud Health Technol Inform ; 315: 246-250, 2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-39049262

RESUMO

To break through the current bottleneck in home-based older care globally, we developed an intelligent and integrated older care model (SMART model) to facilitate integrated care for home-dwelling older people. As a knowledge-based clinical decision support system, the SMART model relies on rules and algorithms to ensure its transparent and well-supported decision-making process with clear rationales. Therefore, we conducted a mixed study combining qualitative research, literature review of the latest literature and guidelines, and expert consultation. Following the intervention mapping framework and nursing process, we determined 138 care problems along with their diagnostic criteria and care goals. Building upon this, we curated 450 evidence-informed methods, each accompanied by at least one implementation approach. Two sets of IF-THEN rules and algorithms including diagnostic rules and method trigger rules were employed to trigger appropriate care problems and customized methods and implementation approaches.


Assuntos
Algoritmos , Sistemas de Apoio a Decisões Clínicas , Humanos , Idoso , Serviços de Assistência Domiciliar , Prestação Integrada de Cuidados de Saúde , Serviços de Saúde para Idosos
2.
J Neuroimmune Pharmacol ; 19(1): 31, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38886223

RESUMO

Neuroinflammation is a key factor in cognitive dysfunction and neurodegenerative diseases such as Alzheimer's disease (AD), so inhibiting neuroinflammation is considered as a potential treatment for AD. Epigallocatechin-3-gallate (EGCG), a polyhydroxyphenol of green tea, has been found to exhibit anti-oxidative, anti-inflammatory and neuroprotective effects. The aim of this study was to investigate the inhibitory effect of EGCG on inflammation and its mechanism. In this study, BV2 cells were simultaneously exposed to lipopolysaccharides (LPS) and the amyloid-ß oligomer (AßO) to induce inflammatory microenvironments. Inflammatory cytokines and NLRP3 inflammasome-related molecules were detected by RT-PCR and Western Blot. The results show that EGCG inhibits LPS/AßO-induced inflammation in BV2 cells through regulating IL-1ß, IL-6, and TNF-α. Meanwhile, EGCG reduces the activation of the NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3) inflammasome and levels of intracellular ROS in BV2 cells treated with LPS/AßO by affecting the mitochondrial membrane potential (MMP). Further research found that EGCG inhibited MMP through regulating thioredoxin-interacting protein (TXNIP) in LPS/AßO-induced neuroinflammation. In conclusion, EGCG may alleviate LPS/AßO-induced microglial neuroinflammation by suppressing the ROS/ TXNIP/ NLRP3 pathway. It may provide a potential mechanism underlying the anti-inflammatory properties of EGCG for alleviating AD.


Assuntos
Peptídeos beta-Amiloides , Proteínas de Transporte , Catequina , Lipopolissacarídeos , Proteína 3 que Contém Domínio de Pirina da Família NLR , Doenças Neuroinflamatórias , Espécies Reativas de Oxigênio , Transdução de Sinais , Catequina/análogos & derivados , Catequina/farmacologia , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Lipopolissacarídeos/toxicidade , Animais , Peptídeos beta-Amiloides/toxicidade , Camundongos , Espécies Reativas de Oxigênio/metabolismo , Proteínas de Transporte/metabolismo , Transdução de Sinais/efeitos dos fármacos , Doenças Neuroinflamatórias/tratamento farmacológico , Doenças Neuroinflamatórias/metabolismo , Linhagem Celular , Tiorredoxinas/metabolismo , Microglia/efeitos dos fármacos , Microglia/metabolismo
3.
BMC Cancer ; 24(1): 422, 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38580944

RESUMO

BACKGROUND: As comprehensive surgical management for gastric cancer becomes increasingly specialized and standardized, the precise differentiation between ≤T1 and ≥T2 gastric cancer before endoscopic intervention holds paramount clinical significance. OBJECTIVE: To evaluate the diagnostic efficacy of contrast-enhanced gastric ultrasonography in differentiating ≤T1 and ≥T2 gastric cancer. METHODS: PubMed, Web of Science, and Medline were searched to collect studies published from January 1, 2000 to March 16, 2023 on the efficacy of either double contrast-enhanced gastric ultrasonography (D-CEGUS) or oral contrast-enhanced gastric ultrasonography (O-CEGUS) in determining T-stage in gastric cancer. The articles were selected according to specified inclusion and exclusion criteria, and the quality of the included literature was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 scale. Meta-analysis was performed using Stata 12 software with data from the 2 × 2 crosslinked tables in the included literature. RESULTS: In total, 11 papers with 1124 patients were included in the O-CEGUS analysis, which revealed a combined sensitivity of 0.822 (95% confidence interval [CI] = 0.753-0.875), combined specificity of 0.964 (95% CI = 0.925-0.983), and area under the summary receiver operating characteristic (sROC) curve (AUC) of 0.92 (95% CI = 0.89-0.94). In addition, five studies involving 536 patients were included in the D-CEGUS analysis, which gave a combined sensitivity of 0.733 (95% CI = 0.550-0.860), combined specificity of 0.982 (95% CI = 0.936-0.995), and AUC of 0.93 (95% CI = 0.91-0.95). According to the I2 and P values ​​of the forest plot, there was obvious heterogeneity in the combined specificities of the included papers. Therefore, the two studies with the lowest specificities were excluded from the O-CEGUS and D-CEGUS analyses, which eliminated the heterogeneity among the remaining literature. Consequently, the combined sensitivity and specificity of the remaining studies were 0.794 (95% CI = 0.710-0.859) and 0.976 (95% CI = 0.962-0.985), respectively, for the O-CEDUS studies and 0.765 (95% CI = 0.543-0.899) and 0.986 (95% CI = 0.967-0.994), respectively, for the D-CEGUS studies. The AUCs were 0.98 and 0.99 for O-CEGUS and D-CEGUS studies, respectively. CONCLUSION: Both O-CEGUS and D-CEGUS can differentiate ≤T1 gastric cancer from ≥T2 gastric cancer, thus assisting the formulation of clinical treatment strategies for patients with very early gastric cancer. Given its simplicity and cost-effectiveness, O-CEGUS is often favored as a staging method for gastric cancer prior to endoscopic intervention.

4.
Mol Biotechnol ; 2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38407690

RESUMO

In hepatic fibrosis (HF), hepatic stellate cells (HSCs) form the extracellular matrix (ECM), and the pathological accumulation of ECM in the liver leads to inflammation. Our previous research found that miR-324-3p was down-regulated in culture-activated human HSCs. However, the precise effect of miR-324-3p on HF has not been elucidated. In this study, the HF mouse models were induced through directly injecting carbon tetrachloride (CCl4) into mice; the HF cell models were constructed using TGF-ß1-treated LX-2 cells. Next, real-time-quantitative polymerase chain reaction (RT-qPCR), western blot (WB) and immunohistochemistry (IHC) were applied to assess the expression levels of miR-324-3p, α-smooth muscle actin (α-SMA), Vimentin or SMAD4; hematoxylin and eosin (H&E), Masson' s trichrome and Sirius red staining to evaluate the liver injury; luciferase reporter assay to verify the targeting relationship between miR-324-3p and SMAD4; enzyme-linked immunosorbent assay (ELISA) to determine the levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST); and cell counting kit-8 (CCK-8) and flow cytometry to evaluate the effects of miR-324-3p on cell proliferation and cycle/apoptosis, respectively. The experimental results showed a reduction in miR-324-3p level in CCl4-induced HF mice as well as transforming growth factor (TGF)-ß1-activated HSCs. Interestingly, the miR-324-3p level was rescued following the HF recovery process. In HF mice induced by CCl4, miR-324-3p overexpression inhibited liver tissue damage, decreased serum ALT and AST levels, and inhibited fibrosis-related biomarkers (α-SMA, Vimentin) expression, thereby inhibiting HF. Similarly, miR-324-3p overexpression up-regulated α-SMA and Vimentin levels in HF cells, while knockdown of miR-324-3p had the opposite effect. Besides, miR-324-3p played an antifibrotic role through inhibiting the proliferation of hepatocytes. Further experiments confirmed that miR-324-3p targeted and down-regulated SMAD4 expression. SMAD4 was highly expressed in HF cells, and silencing SMAD4 significantly decreased the α-SMA and Vimentin levels in HF cells. Collectively, the miR-324-3p may suppress the activation of HSCs and HF by targeting SMAD4. Therefore, miR-324-3p is identified as a potential and novel therapeutic target for HF.

6.
Horm Metab Res ; 55(9): 585-591, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37500084

RESUMO

To study risk factors for central lymph node metastasis (CLNM) in papillary thyroid cancer (PTC) using the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS). We retrospectively analysed patients who underwent PTC surgery and central lymph node dissection at First People's Hospital of Foshan City. The clinical and ultrasonic data of the patients from 1150 cases were analysed by multivariate regression to evaluate the correlation between grayscale ultrasound (US) features, C-TIRADS score, and the classification of thyroid nodules and CLNM of PTCs. The C-TIRADS score was 3.0±1.0 in the CLNM group, which was higher than that in the non-CLNM group (p<0.001). Sex (male) (OR=1.586, 95% CI 1.232-2.042, p<0.001), age (≤45 years) (OR=1.508, 95% CI 1.184-1.919, p=0.001), location of nodes (lower pole) (OR=2.193, 95% CI 1.519-3.166, p<0.001), number (multifocal) (OR=2.204, 95% CI 1.227-2.378, p<0.001), microcalcification (OR=1.610, 95% CI 2.225-4.434, p=0.002), extrathyroidal extension (OR=2.204, 95% CI 1.941-3.843, p<0.001), maximum diameter of nodule (≥20 mm) (OR=3.211, 95% CI 2.337-4.411, p<0.001), and C-TIRADS score (OR=1.356, 95% CI 1.204-1.527, p<0.001) were PTC in independent risk factors for CLNM. The C-TIRADS score of PTC combined with the location, number, size, and ultrasound features of the lesion and the patient's sex and age are important in predicting whether they present with CLNM and provide a reference basis for the clinical formulation of a reasonable surgical treatment plan.


Assuntos
Neoplasias da Glândula Tireoide , Humanos , Masculino , Pessoa de Meia-Idade , Câncer Papilífero da Tireoide/secundário , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Estudos Retrospectivos , Metástase Linfática , Fatores de Risco
7.
Ultrasound Med Biol ; 49(9): 2177-2182, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37423829

RESUMO

OBJECTIVE: Abdominal ultrasonography after transrectal filling with contrast agent (AU-TFCA) was retrospectively evaluated with respect to determination of T stage and lesion length in patients with colorectal cancer (CRC) who had previously failed colonoscopy because of severe intestinal stenosis. METHODS: The population comprised 83 patients with CRC with intestinal stenosis and previously failed colonoscopy who underwent AU-TFCA, and in addition contrast-enhanced computed tomography (CECT) and/or magnetic resonance imaging (MRI), 2 wk before surgery. The diagnostic performance of AU-TFCA and CECT/MRI was evaluated relative to the post-operative pathological results (PPRs) by paired sample t-test, receiver operator characteristic (ROC) curve, Pearson's χ2-test and κ and intraclass correlation coefficients. RESULTS: The T staging identified via AU-TFCA, but not CECT/MRI, was relatively consistent with that of the PPRs (linearly weighted κ coefficient: 0.558, p < 0.001, and linearly weighted κ coefficient: 0.237, p < 0.001, respectively). The overall diagnostic accuracy of T staging based on AU-TFCA (83.1%) was significantly higher than that based on CECT/MRI (50.6%). Regarding lesion length, the results of AU-TFCA and PPRs were comparable (t = 1.852, p = 0.068), but those of CECT/MRI and PPRs were significantly different (t = 8.450, p < 0.001). CONCLUSION: AU-TFCA is effective in evaluation of lesion length and T stage in patients with severely stenotic CRC lesions who previously failed colonoscopy. The diagnostic accuracy of AU-TFCA is significantly better compared with that of CECT/MRI.


Assuntos
Neoplasias Colorretais , Meios de Contraste , Humanos , Estudos Retrospectivos , Constrição Patológica/diagnóstico por imagem , Ultrassonografia , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/patologia , Imageamento por Ressonância Magnética/métodos
8.
PLoS One ; 18(5): e0285508, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37163524

RESUMO

BACKGROUND: Coronary atherosclerotic heart disease (CAD) remains one of the most serious diseases threatening human health and life. PCI (Percutaneous Coronary Intervention) is the most common treatment for patients with CAD. A rigorous and comprehensive assessment of coronary artery lesions is now needed before PCI, however, there is no consensus on how best evaluate the combination of various intracavitary imaging techniques. By merging the benefits of physiological assessment and high-definition imaging, the optical flow ratio (OFR) has emerged as a novel technology with promising prospects for application. METHODS: A systematic review of the literature was conducted. Studies that met the criteria of the meta-analysis were considered to assess OFR and FFR (fractional flow reserve). And the summary values of sensitivity and specificity of diagnostic tests and summary receiver operating curves (SROC) were calculated. RESULTS: A total of 5 studies were included. The sensitivity and specificity of OFR in the diagnosis of coronary artery lesions were 0.83 (95% CI: 0.75-0.88) and 0.94 (95% CI: 0.91-0.96), respectively; the positive likelihood ratio and the negative likelihood ratio were 14 (95% CI: 9.3, 21.3) and 0.18 (95% CI:0.13, 0.27), respectively. OFR showed good correlation and consistency with FFR. CONCLUSION: The new OFR technique achieve an encouraging diagnostic performance, which also showed good correlation and consistency with FFR.


Assuntos
Doença da Artéria Coronariana , Estenose Coronária , Reserva Fracionada de Fluxo Miocárdico , Fluxo Óptico , Intervenção Coronária Percutânea , Humanos , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Estenose Coronária/diagnóstico , Reserva Fracionada de Fluxo Miocárdico/fisiologia , Valor Preditivo dos Testes
9.
Microbiol Spectr ; : e0398322, 2023 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-36946733

RESUMO

Plasma metagenomic next-generation sequencing (mNGS) testing is a promising diagnostic modality for infectious diseases, but its real-world clinical impact is poorly understood. We reviewed patients who had undergone plasma mNGS at a general hospital to evaluate the clinical utility of plasma mNGS testing. A total of 76.9% (113/147) of plasma mNGS tests had a positive result. A total of 196 microorganisms (58) were identified and reported, of which 75.6% (148/196) were clinically relevant. The median stringent mapped read number (SMRN) of clinically relevant organisms was 88 versus 22 for irrelevant organisms (P = 0.04). Based on the clinically adjudicated diagnosis, the positive and negative percent agreements of plasma mNGS testing for identifying a clinically defined infection were 95.2% and 67.4%, respectively. The plasma mNGS results led to a positive impact in 83 (57.1%) patients by diagnosing or ruling out infection and initiating targeted therapy. However, only 32.4% (11/34) of negative mNGS tests showed a positive impact, suggesting that plasma mNGS testing alone may not be a powerful tool to rule out infection in clinical practice. In the subset of 37 patients positive for both plasma mNGS and conventional testing, mNGS identified the pathogen(s) 2 days (IQR = 0.75 to 4.25) earlier than conventional testing. mNGS enables pathogen identification within 24 h, but given that the detection of clinically irrelevant organisms and nearly half of the tests result in no or a negative clinical impact, more clinical practice and studies are required to better understand who and when to test and how to optimally integrate mNGS into the infectious disease diagnostic workup. IMPORTANCE In this study, we show that although plasma mNGS testing significantly improved the detection rate of tested samples, nearly one in four (24.5%, 48/196) mNGS tests reported organisms were not clinically relevant, emphasizing the importance of cautious interpretation and infectious disease consultation. Moreover, based on clinical adjudication, plasma mNGS testing resulted in no or a negative impact in nearly half (43.5%, 64/147) of patients in the current study, indicating that how best to integrate this advanced method into current infectious disease diagnostic frameworks to maximize its clinical utility in real-world practice is an important question. Therefore, recommending plasma mNGS testing as a routine supplement to first-line diagnostic tests for infectious diseases faces great challenges. The decision to conduct mNGS testing should take into account the diagnostic performance, turnaround time and cost-effectiveness of mNGS, as well as the availability of conventional tests.

10.
Intensive Crit Care Nurs ; 76: 103394, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36731263

RESUMO

OBJECTIVE: To investigate the effect of video visitation on intensive care patients' and family members' outcomes during the COVID-19 pandemic. DESIGN: This is a randomised controlled trial. SETTING: An adult intensive care unit in a tertiary hospital in Beijing, China. METHODS: A total of 121 adults, who were >18 years of age, conscious, able to communicate verbally, and admitted to the intensive care unit for over 24 hours were randomised into the intervention (video visitation) (n = 65) and control (n = 56) Groups. A total of 98 family members participated. Patient primary outcomes included anxiety and depression, measured using the Hospital Anxiety and Depression Scale. Secondary outcomes included patient delirium and family anxiety assessed using the Confusion Assessment Method scale and Self-Rating Anxiety Scale, respectively; and patient and family satisfaction, measured using a questionnaire routinely used in the hospital. RESULTS: There were no statistically significant differences between the groups in patients' anxiety (t = 1.328, p = 0.187) and depression scores (t = 1.569, p = 0.119); and no statistically significant differences in delirium incidence between the groups (7.7 % vs 7.1 %, p > 0.05). There were no significant differences in changes in family members' anxiety scores (t = 0.496, p = 0.621). A statistically significant difference in satisfaction was found between the two group patients (86.1 % vs 57.2 % of patients were satisfied with using video visitation, p < 0.05), and the result of family members' satisfaction was also statistically significant (88 % vs 62.5 % of family members were satisfied with using video visitation, p < 0.05). CONCLUSION: Video visitation did not seem to influence anxiety, but the use of video visitation can improve the patient and their family members' satisfaction. Future research is needed to determine the feasibility of embedding video visitation into routine practice, and the optimal frequency and length of video visitation in relation to patients' and family members' outcomes. IMPLICATIONS FOR CLINICAL PRACTICE: Video visitation improved patient and family members' satisfaction. Therefore, clinicians should consider using video visitation when face to face visit is restricted. Video visVitation did not reduce patient anxiety significantly in this study maybe because the average length of intensive care stay was too short. Future research is needed on its effect on long term intensive care patients.


Assuntos
COVID-19 , Delírio , Adulto , Humanos , Pandemias , Visitas a Pacientes , Família , Cuidados Críticos , Unidades de Terapia Intensiva
11.
Aust Crit Care ; 36(4): 669-675, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35787817

RESUMO

INTRODUCTION: Catheter-related bloodstream infections are among the most critical adverse events in critical patients with peripheral arterial catheters (ACs). Adherence to evidence-based guidelines can prevent and reduce arterial bloodstream infections. OBJECTIVE: The objectives of this study were to assess clinical practice guidelines for AC care and analyse methodological factors related to their development for effective dissemination and implementation in clinical practice. REVIEW METHOD USED: This was a systematic review of guidelines. DATA SOURCES: We searched PubMed, CINAHL, EMBASE, CNKI, and WANFANG databases from inception until September 2021 and evaluated websites of organisations that complied or produced guidelines. REVIEW METHODS: A comprehensive list of guidelines for ACs care was included. We excluded incomplete guidelines, guidelines translated in other languages, duplicate publications, and summaries of multiple guidelines. Two reviewers independently extracted and collected the data, and three authors conducted quality assessments independently using the Appraisal of Guidelines for Research and Evaluation, Second Edition (AGREE II) tool. The intraclass correlation coefficient (two-way random) with a 95% confidence interval was used to evaluate the concordance between reviewers. RESULTS: Of the 738 total publications screened, seven were selected for evaluation. The concordance between observers was substantial (intraclass correlation coefficient >0.9, P < 0.001). Most guidelines (4/6) were developed in the United States and the United Kingdom. The median scores for the six domains were 89.0%, 65.5%, 58.0%, 86.0%, 65.0%, and 86.0%. The domains of stakeholder involvement, rigour of development, and applicability had the lowest scores. Guidelines by the United Kingdom's National Institute for Health and Care Excellence showed the highest quality. CONCLUSIONS: The guidelines we included scored poorly on crucial domains (rigour of development, applicability, and stakeholder involvement). Most of the current recommendations on ACs were included in the guidelines for vascular catheter-related bloodstream infections. Therefore, targeted guidelines created specifically for ACs are warranted to reduce the incidence of catheter-related complications and ensure patient safety.


Assuntos
Cateterismo Periférico , Dispositivos de Acesso Vascular , Humanos , Cateterismo Periférico/efeitos adversos , Reino Unido
12.
J Vasc Access ; : 11297298221129000, 2022 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-36239457

RESUMO

BACKGROUND: Peripheral arterial catheters (AC) are increasingly used in intensive care units (ICUs). Arterial catheter-related bloodstream infection is a serious complication that can increase patients' morbidity and length of stay. Standardised infection prevention practices are important when using AC. However, the current practices regarding AC insertion, use and removal and the perceived infection prevention attitudes of nurses in ICUs are unknown. METHODS: This was a multicentre cross-sectional study; 20 tertiary general hospitals were selected with a stratified random method in Beijing, China, using a self-reported internet survey. RESULTS: A total of 981 valid questionnaires were collected. Overall, some infection prevention practices, such as AC insertion and disinfection of the blood sample hub, were generally consistent with clinical guidelines, whereas others were inconsistent: eye protection, skin antiseptic solution, dressing choice, blood sample collection and replacement of AC. More than 60% of participants mentioned occasionally or never having used eye protection. Only 6.0% of them stated using the chlorhexidine dressings. Among the participants, 80.6% reported that they replaced AC routinely rather than based on clinical indications, 64.2% self-rated that they did not routinely culture a catheter specimen after removal and 53.4% of participants positively agreed that AC could cause infection. Nurses with a higher education level were more likely to agree that an infection risk with AC exists (trend χ2 = 5.456, p = 0.019*). CONCLUSIONS: Significant heterogeneity exists across hospitals in China in terms of antiseptic techniques and perception of infection prevention during AC insertion, use and removal. Critical care nurses' practices partially complied with guideline recommendations. Educational level was found to be a risk factor for their perceived infection prevention attitudes. Nurses with a lower education level underestimated the infection risk of AC. Future research may examine optimal preventive strategies for reducing infection.

13.
BMJ Open ; 12(9): e064566, 2022 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-36175101

RESUMO

INTRODUCTION: Multidrug-resistant organisms (MDROs) are pathogenic bacteria that are the leading cause of hospital-acquired infection which is associated with high morbidity and mortality rates in intensive care units, increasing hospitalisation duration and cost. Predicting the risk of MDRO colonisation or infection for critically ill patients supports clinical decision-making. Several models predicting MDRO colonisation or infection have been developed; however, owing to different disease scenarios, bacterial species and few externally validated cohorts in different prediction models; the stability and applicability of these models for MDRO colonisation or infection in critically ill patients are controversial. In addition, there are currently no standardised risk scoring systems to predict MDRO colonisation or infection in critically ill patients. The aim of this systematic review is to summarise and assess models predicting MDRO colonisation or infection in critically ill patients and to compare their predictive performance. METHODS AND ANALYSIS: We will perform a systematic search of PubMed, Cochrane Library, CINAHL, Embase, Web of science, China National Knowledge Infrastructure and Wanfang databases to identify all studies describing the development and/or external validation of models predicting MDRO colonisation or infection in critically ill patients. Two reviewers will independently extract and review the data using the Data Extraction for Systematic Reviews of Prediction Modelling Studies checklist; they will also assess the risk of bias using the Prediction Model Risk of Bias Assessment Tool. Quantitative data on model predictive performance will be synthesised in meta-analyses, as applicable. ETHICS AND DISSEMINATION: Ethical permissions will not be required because all data will be extracted from published studies. We intend to publish our results in peer-reviewed scientific journals and to present them at international conferences on critical care. PROSPERO REGISTRATION NUMBER: CRD42022274175.


Assuntos
Estado Terminal , Farmacorresistência Bacteriana Múltipla , Humanos , Modelos Estatísticos , Extratos Vegetais , Prognóstico , Revisões Sistemáticas como Assunto
14.
World J Clin Cases ; 10(19): 6728-6735, 2022 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-35979295

RESUMO

BACKGROUND: Familial hypercholesterolemia (FH) is an autosomal dominant disorder that is characterized by severely increased low-density lipoprotein (LDL) cholesterol levels. At the same time, elevated LDL levels accelerated the development of coronary heart disease. Several classes of drugs are currently in use to treat FH. Proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i) is novel one of these. CASE SUMMARY: This manuscript reports a case of FH that responded modestly after treatment with PCSK9i and statin drugs. Of even more concern is that the patient frequently admitted to the hospital during a 12-year follow-up period. Subsequently, we identified a heterozygous mutation, 1448G>A (W483X) of the LDL receptor (LDLR) in this patient. The serum levels of PCSK9 (proprotein convertase subtilisin/kexin type 9) in the patient was 71.30 ± 26.66 ng/mL, which is close the average level reported in the literature. This LDLR mutation affects LDLR metabolism or structure, which may make it unsuitable for use of PCSK9i. CONCLUSION: Our outcome demonstrates that LDLR-W483X represents a partial loss-of-function LDLR and may contribute to PCSK9i ineffective. In the meanwhile, additional measures are therefore required (particularly with gene sequencing or change the treatment plan) must be initiated as early as possible. Genetic testing for clinically challenging cases who do not respond to PCSK9i therapy is very helpful.

15.
Front Pediatr ; 10: 866010, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35573961

RESUMO

Background: Left main coronary artery atresia (LMCAA) is an extremely rare abnormality and only <100 cases have been reported worldwide. We describe the clinical manifestations, imaging features, prognosis, and treatments of LMCAA who were admitted in our department, which aimed to improve the clinical diagnosis and treatments of LMCAA in children. Methods: A retrospective study identified 12 patients diagnosed with congenital left coronary artery atresia at Pediatric Heart Center of Beijing Anzhen Hospital from June 2010 to June 2019. The clinical characteristics, imaging data, and treatment follow-up were analyzed. Results: Among the 12 cases, 8 were boys and 4 were girls; the age of onset was 2 months to 2 years old (median age 7 months); the age of diagnosis was 7 months to 6 years old (median age 2 years and 11 months). At the initial diagnosis, there were 4 cases of respiratory tract infection with cardiac murmur, 3 cases of cardiac shadow enlargement, 1 case of recurrent syncope, 2 cases of feeding difficulty with cardiac enlargement, and 2 cases of simple cardiac murmur. In 12 cases of electrocardiogram examination, 7 cases showed pathological Q waves of lead I, AVL and v4-v6; in 12 cases of chest X-ray examination, 8 cases showed cardiac shadow enlargement; in 12 cases of our hospital's first cardiac ultrasound examination, 4 cases were definitely diagnosed, and 8 cases showed the possibility of left coronary artery abnormality; in 5 cases of cardiac coronary CT angiography examination, 2 cases were confirmed, 2 cases reported suspected left coronary artery abnormality, and 1 case did not report abnormality; All cases were definitely diagnosed in 8 cases of angiography. Follow-up was performed from 1 to 8 years; one case died suddenly, one case of syncope after activity was treated by oral medication, 3 cases received open coronary angioplasty and mitral valvuloplasty, recovered well after operation, the rest of the children were treated by oral medication, and the symptoms are stable at present. Conclusions: Left main coronary artery atresia is difficult to diagnose and can result in heart failure early in life. Timely diagnosis and reasonable treatment are the keys to improve the prognosis.

16.
J Hazard Mater ; 435: 128946, 2022 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-35468395

RESUMO

Membrane biofilm (MBf) technology is a promising biological water treatment process that combines membrane aeration with biofilms. To expand its application in the treatment of toxic organic wastewater, methane/air gas mixture-MBfs ((CH4 + Air)-MBfs) and air-MBfs were coupled to enhance the treatment of p-nitroaniline (PNA) wastewater. Based on exploration of the membrane permeability of methane and oxygen, a hybrid MBf reactor was constructed, and the degradation characteristics of PNA and the coupling effects of (CH4 + Air)-MBfs and air-MBfs were studied. The permeation flux of methane was found to be 1.114 g/(m2 d) when using a methane/air gas mixture at an aeration pressure of 10 kPa, and this result was better than that when methane was used as the aeration gas alone. Aeration with a methane/air gas mixture provided conditions for realizing aerobic methane oxidation; the aerobic methane oxidation that occurred in the (CH4 + Air)-MBfs promoted the reduction of PNA, and the intermediates of PNA degradation were further degraded by the air-MBfs. At an influent PNA membrane area load of 1.67 g/(m2 d), the PNA removal load reached 187.30 g/(m3 d). The coupling of MBfs took advantage of different matrix-based MBfs and promoted the degradation of PNA by utilizing the synergistic effects of various functional microorganisms.


Assuntos
Metano , Águas Residuárias , Compostos de Anilina , Biofilmes , Reatores Biológicos , Metano/metabolismo , Oxirredução
17.
J Sci Food Agric ; 102(11): 4892-4908, 2022 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-35246843

RESUMO

BACKGROUND: Wheat floret development has been a focus of research due to a desire to improve spike fertility, which majorly influences grain yield. Sowing date plays a vital role on grain yield in wheat, and increase in the grain number per spike of winter wheat (Triticum aestivum L.) has been obtained by delayed sowing. During the 2014-2015 and 2015-2016 growing seasons, variation in these developmental patterns was explored involving two winter wheat cultivars (Jimai 22 and Tainong 18) and five sowing dates (24 September; 1, 8, 15 and 22 October). RESULTS: We noticed clear differences in the grain number per spikelet; delayed sowing had a greater impact on the number of fertile florets at anthesis than grain set. Significant differences in the developmental patterns of florets among spikelet positions corresponded to variations in the floret developmental rate, with faster floret development associated with higher floret fertility. Delayed sowing did not affect the grain number near the rachis, but significantly promoted grain set on distal florets. Increased spike dry weight (SDW) did not compensate for floret size or grain weight, mainly due to enhanced assimilate partitioning to florets. CONCLUSION: Delayed sowing significantly affects floret developmental dynamics, causing differences in winter wheat floret fertility. An increased SDW concomitant with improved intra-spike partitioning before anthesis contributes to increase the distal floret numbers per spike and then optimize winter wheat spike fertility. © 2022 Society of Chemical Industry.


Assuntos
Flores , Triticum , Grão Comestível , Fertilidade , Estações do Ano
18.
Ecotoxicol Environ Saf ; 231: 113189, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35033875

RESUMO

The present study mimicked daily life exposure to plastic food package bags and evaluated its effects on the reproductive and neurobehavioral responses using zebrafish model. Gas chromatography-mass spectrometer (GC/MS) full scan analysis revealed that phthalic acid, isobutyl octyl ester (DEHP) and its metabolites were the main leachate from plastic bags. Our results demonstrated that during the eight weeks exposure, leaching from plastic bags treated with boiling water (P-high group) significantly affected the spawn egg production, embryo hatching and larval malformation rate. Cross-spawning trails between zebrafish collected from the controls and P-high group at the end of eight weeks showed that these adverse effects were more severe in the offspring derived from paternal exposure than those derived from the maternal exposure, suggesting leached chemicals may have a more pronounced effect in sperm than in eggs. In addition, P-high group male testis weight, sperm motility and sperm swimming velocities were decreased significantly. After eight weeks treatment, neurobehavioral tests demonstrated significant changes in the swimming speed during free swimming and light-dark stimulation in the adult zebrafish from P-high group, with the effects being more severe in the males than females. P-high group males also showed altered response in the light/dark explore and mirror attacks assays.


Assuntos
Poluentes Químicos da Água , Peixe-Zebra , Animais , Feminino , Embalagem de Alimentos , Masculino , Plásticos/toxicidade , Reprodução , Motilidade dos Espermatozoides , Poluentes Químicos da Água/toxicidade
19.
Nurs Crit Care ; 27(5): 682-688, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-33709551

RESUMO

BACKGROUND: Maintaining the patency of arterial catheters-routinely inserted in critically ill patients in intensive care units (ICUs)-is essential for obtaining physiological measurements and enabling blood sampling. AIM: This study aims to evaluate current ICU nurse knowledge and practice of maintaining the patency of arterial catheters and explore the factors that influence nurses' knowledge level. DESIGN: This was a cross-sectional survey conducted in China. METHODS: This research was conducted in 20 tertiary hospitals in Beijing, China between March and June 2020. The data were collected by electronic questionnaire, which was designed in accordance with the literature and consisted of 28 questions. Descriptive and inferential statistics were used to analyse the data. RESULTS: A total of 576 completed questionnaires were returned. The mean score of nurses' knowledges was 3.66 ± 1.35, which is a moderate level. There was a statistically significant difference between the mean scores of nurses with different professional titles and work experiences (mean 3.58 vs 4.04/7; mean 3.50 vs 3.58 vs 3.94/7). Considering ICU nurses' practice of maintaining the patency of arterial catheters, 376(65.3%)nurses replaced the pressure transducer as per the manual, and 347 (60.2%) nurses zeroed the pressure transducer once per shift. More than 90% ICU nurses aligned the transducer with the heart surface marker during zeroing procedures. Furthermore, 79.9% of nurses performed fast-flush tests routinely, 459 (85.9%) nurses flushed the arterial catheter routinely, and 80% of nurses evaluated the patency of the arterial catheter every shift. CONCLUSIONS: This study found that the practices of ICU nurses varied, and their knowledge of how to maintain the patency of arterial catheters was moderate and could be improved. ICU nurses should be trained effectively to develop a unified standard of arterial catheter management. RELEVANCE TO CLINICAL PRACTICE: Training programmes on arterial catheter management for ICU nurses are essential for improving knowledge and practice.


Assuntos
Cateterismo Periférico , Enfermeiras e Enfermeiros , Cateteres de Demora , Competência Clínica , Estudos Transversais , Humanos , Unidades de Terapia Intensiva , Inquéritos e Questionários
20.
J Card Surg ; 36(6): 2029-2034, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33738816

RESUMO

OBJECTIVE: This study aimed to evaluate the long-term outcomes of patients with patent ductus arteriosus (PDA) associated with unilateral absence of a pulmonary artery (UAPA). METHODS: Patients diagnosed with PDA associated with UAPA between January 2005 and June 2019 were retrospectively enrolled in this study. Demographic and clinical characteristics, treatments, and follow-up information were evaluated. RESULTS: A total of 11 patients were diagnosed with PDA associated with UAPA. Percutaneous closure was successfully conducted in nine patients. The mean diameters of the PDA measured by aortogram and occluders were 5.3 ± 1.8 mm and 11.5 ± 3.9 mm, respectively. The median pulmonary systemic flow ratio (Qp:Qs) in five patients was 1.41, and the median total lung resistance was 12 Wood Units. The mean systolic pulmonary artery (PA) pressure was 68.3 ± 19.1 mmHg. In five patients with pre- and postprocedure catheter data, the systolic pulmonary arterial pressure decreased significantly after closure (from 77.0 ± 20.2 to 58.8 ± 17.5 mmHg; p = .024), as did the mean pulmonary arterial pressure (from 58.2 ± 14.6 to 39.0 ± 14.1 mmHg; p = .18). The PA pressure and heart size gradually decreased to normal levels in eight patients, and their quality of life was significantly improved. The ratio of lung to systemic circulation pressure was less than 0.75. CONCLUSIONS: In appropriate patients with PDA associated with UAPA, transcatheter closure of PDA has the potential to improve PA hypertension. A ratio of lung to systemic circulation pressure less than 0.75 may be an important reference index for predicting whether PA pressure can be reduced to a normal level after occlusion.


Assuntos
Permeabilidade do Canal Arterial , Cateterismo Cardíaco , Permeabilidade do Canal Arterial/diagnóstico por imagem , Permeabilidade do Canal Arterial/cirurgia , Humanos , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Qualidade de Vida , Estudos Retrospectivos , Sístole , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA